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Anxiolytic Drugs: Benzodiazepines and Buspirone01:29

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Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
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Sedatives and Hypnotics Drugs: Benzodiazepines01:19

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
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CNS Depressants: Barbiturates and Benzodiazepines01:14

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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Sedatives and Hypnotics: Overview01:23

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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
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Anxiolytic Drugs: Overview01:26

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Anxiolytic drugs are vital in managing anxiety disorders by effectively alleviating symptoms such as excessive fear, tachycardia, and tremors. There are several classes of anxiolytic medications, each with unique mechanisms of action and potential side effects.
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Drug Dosage Regimen: Overview01:15

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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Benzodiazepine Initiation and Dose Escalation.

Brian W Skinner1,2, Elizabeth V Johnston2, Lindsay M Saum2,3

  • 11 Manchester University College of Pharmacy, Natural and Health Sciences, Fort Wayne, IN, USA.

The Annals of Pharmacotherapy
|November 30, 2016
PubMed
Summary

Initiating or increasing doses of benzodiazepines (BZDs) significantly raises fall risk in hospitalized patients. Judicious BZD use in hospitals is crucial to prevent patient falls.

Keywords:
adult medicinebenzodiazepinesdrug safetygeneral medicinemedication safety

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Patient Safety

Background:

  • Benzodiazepines (BZDs) are associated with a significant risk of falls.
  • Existing literature lacks data on whether BZD initiation or dose escalation exacerbates fall risk.

Purpose of the Study:

  • To investigate if starting or increasing benzodiazepine (BZD) doses increases fall risk in hospitalized patients.
  • To compare fall risk between patients whose BZD dose was initiated/escalated versus those maintained or decreased.

Main Methods:

  • Retrospective case-control study of hospitalized patients aged 45+ receiving BZDs.
  • Compared BZD regimens before and 48 hours prior to the index date (fall date or median time-to-fall).
  • Included 33 fallers and 99 controls (3:1 ratio).

Main Results:

  • Patients who fell had a longer median length of stay (15 vs. 10 days).
  • A higher percentage of fallers had their BZD regimen initiated or dose escalated (63.6% vs. 41.4%).

Conclusions:

  • Initiating or escalating benzodiazepine (BZD) doses increases the risk of falls in hospitalized patients.
  • Hospitals should carefully manage BZD use in inpatients to mitigate fall risks.